• Clinical and Experimental Pediatrics
• /
• 제46권10호
• /
• pp.1040-1043
• /
• 2003

저자들은 9세 남아에서 고혈압과 뇌혈관염이 동반된 상태에서 뇌증을 보인 HSP 신염 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
• /
• 제32권1호
• /
• pp.26-30
• /
• 2015

Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

• Clinical and Experimental Pediatrics
• /
• 제59권10호
• /
• pp.408-413
• /
• 2016

Purpose: This study investigated predictors of unresponsiveness to second-line intravenous immunoglobulin (IVIG) treatment for Kawasaki disease (KD). Methods: This was a single-center analysis of the medical records of 588 patients with KD who had been admitted to Asan Medical Center between 2006 and 2014. Related clinical and laboratory data were analyzed by univariate and multivariate logistic regression analyses. Results: Eighty (13.6%) of the 588 patients with KD were unresponsive to the initial IVIG treatment and received a second dose. For these 80 patients, univariate analysis of the laboratory results obtained before administering the second-line IVIG treatment showed that white blood cell count, neutrophil percent, hemoglobin level, platelet count, serum protein level, albumin level, potassium level, and C-reactive protein level were significant predictors. The addition of methyl prednisolone to the second-line regimen was not associated with treatment response (odds ratio [OR], 0.871; 95% confidence interval [CI], 0.216-3.512; P=0.846). Multivariate analysis revealed serum protein level to be the only predictor of unresponsiveness to the second-line treatment (OR, 0.160; 95% CI, 0.028-0.911; P=0.039). Receiver operating characteristic curve analysis to determine predictors of unresponsiveness to the second dose of IVIG showed a sensitivity of 100% and specificity of 72% at a serum protein cutoff level of <7.15 g/dL. Conclusion: The serum protein level of the patient prior to the second dose of IVIG is a significant predictor of unresponsiveness. The addition of methyl prednisolone to the second-line regimen produces no treatment benefit.

• 대한수의학회지
• /
• 제56권3호
• /
• pp.139-145
• /
• 2016

This study was conducted to determine the effect of treatment with intravenous human immunoglobulin G (hIVIgG) on outcome in dogs with idiopathic immune-mediated hemolytic anemia (IMHA), and to identify prognostic variables that determine outcome in affected dogs. Thirty-seven dogs that met the inclusion criteria were enrolled in a retrospective study. The dogs were categorized into two groups based on their having received hIVIgG. There was no significant difference in survival between the hIVIgG group and the non-hIVIgG group. Mortality during hospitalization and at 1 month, 1 year, or 2 years after discharge was not significantly different between the hIVIgG and the non-hIVIgG groups. Hemoglobinuria was significantly less prevalent in dogs that lived more than 1 year than in those who lived less than 1 year, and was less prevalent in dogs that lived more than 2 years than in those who lived less than 2 years. However, there was no difference in the presence of hemoglobinuria between dogs that lived less than 1 month and those that lived more than 1 month. Overall, there was no evidence of a beneficial effect of hIVIgG in dogs with idiopathic IMHA.

• Pediatric Infection and Vaccine
• /
• 제17권2호
• /
• pp.169-176
• /
• 2010

목적 : 가와사끼병 환자들에서 정맥용 면역글로불린(intravenous immunoglobulin, IVIG) 불응군의 예측 지표를 두 대조군을 사용하여 연구하였다. 방 법 : 가톨릭대학교 대전성모병원에서 IVIG 2 g/kg로 치료한 229명의 가와사끼병 환자들을 대상으로 하였다. 23명 IVIG 불응군(IVIG 투여 후에도 24시간 이상 발열이 지속)과, 첫번째 206명의 IVIG 반응군 및 두번째 연령과 치료 전 발열일을 일치시킨 46명의 대조군에 대해 임상적, 검사실 소견을 비교하였다. 결과 : 인구학적, 임상적 소견은 IVIG 불응군과 반응군이 유사하였다. 검사실 소견에서, 두 가지 연구 모두에서 IVIG 불응군은 반응군에 비해서 중성구 분획, CRP, AST, ALT 그리고, LDH는 유의하게 상승되었고, 림프구 분획, 총 단백질, 알부민, 혈소판 수, 그리고 총 콜레스테롤은 유의하게 저하되어 있었다(단변수분석). 그러나, 다변수분석에서 첫번째 연구에서 높은 중성구 분획(cutoff value, >77%, 민감도 68.4%, 특이도 79.5%)과 낮은 총 콜레스테롤(<124 mg/dL, 민감도 79%, 특이도 70.5%)이, 두번째 연구에서는 알부민(<3.6 g/dL, 민감도 73.7%, 특이도 60%)만이 불응군의 예측 지표로 나타났다. 결론 : 가와사끼병에서 염증의 중증도는 발병 시에 상승되거나 저하된 검사실 소견에 반영된다. 이러한 검사실 지표에 대한 다변수분석은 환아수, 연령 및 발열 기간 등의 인자에 의해서 영향을 받으므로, 관상동맥병변의 위험이 큰 가와사끼병 환자들을 찾기 위한 다른 접근 방법이 필요하다.

• Clinical and Experimental Pediatrics
• /
• 제48권4호
• /
• pp.443-447
• /
• 2005

저자들은 지속되는 발열, 빈혈, 혈소판 감소증, 흉수, 복수 및 간비종대 등의 비특이적인 전신증상을 주소로 내원한 13세 남아를 경부 림프절 조직 검사에서 혼합형의 Castleman병으로 진단한 후 스테로이드와 면역글로불린을 투여하여 호전된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical and Experimental Reproductive Medicine
• /
• 제20권2호
• /
• pp.149-156
• /
• 1993

Human chorionic gonadotropin(hCG) and intravenous immunoglobulin(IVIG) treatment were attempted as a novel therapeutic approach for unexplained recurrent spontaneous abortion(RSA). Forty-four and 3 women with a history of RSA were treated with hCG and IVIG, respectively, during pregnancy. Of these patients, serum blocking factor assay was performed before and after each treatment, in 15 patients; 12 cases with hCG and 3 cases with IVIG. The results were as follows: 1. Of 44 women who receive hCG during pregnancy, 24 delivered healthy infants at term, 10 patients suffered repeat abortion, and 10 women are still pregnant under 28 weeks. Over all success rate of hCG treatment was 70.6% (24/34). Although there is no statistical significance, absolute serm blocking level was decreased after treatment(N=12). 2. Of 3 women who receive IVIG during pregnancy, all 3 women are still pregnant under 28 weeks. Serum blocking level was increased after treatment, however, this increment was not statistically significant. Although no conclusion could be extracted from the patients who received IVIG, the therapeutic effect of hCG is comparable to that of the other therapeutic regimens, such as allogeneic leukocytes. It was postulated that actual etiology of unknown RSA would be classified as hormonal origin although combined etiologies are common in Korean women.

• Clinical and Experimental Pediatrics
• /
• 제45권8호
• /
• pp.1048-1051
• /
• 2002

저자들은 8세 남아에서 고열, 저혈압, 부정형 피부 발진, 의식저하, 결막염, 구토, 설사, 핍뇨, 혈소판 저하, 혈액배양 음성과 같은 독성 쇼크 증후군의 증상과 함께 관상동맥류를 포함한 가와사끼병의 임상증상을 보인, 독성 쇼크 증후군 증상으로 나타난 비전형적 가와 사끼병 1례를 경험하였기에 문헌고찰과 함께 보고하며, 독성 쇼크 증후군의 치료 중 발열이 지속될 때 가와사끼병의 비전형적인 증상 발현일 수 있음을 염두해야 할 것으로 사료된다.

• Pediatric Infection and Vaccine
• /
• 제16권2호
• /
• pp.205-209
• /
• 2009

독성 쇼크 증후군은 황색 포도알균 등에서 생성하는 독소에 의한 고열, 발진 및 쇼크에 병발하는 다발성 장기 부전이 발생하는 증후군이다. 저자들은 화상 후 속발한 독성 쇼크 증후군으로 진단한 환아를 vancomycin, 신선 냉동 혈장, 정맥내면역 글로불린 투여로 치료하고, 화상 부위에서 동정된 CAMRSA의 분자 생물학 및 유전적 특징을 분석하여 이를 보고하는 바이다.

• Kidney Research and Clinical Practice
• /
• 제37권4호
• /
• pp.414-417
• /
• 2018

Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.